Digital discharge tool helps Alabama hospital cut readmissions

From the mHealthNews archive
By Eric Wicklund
08:42 am

How many people, upon leaving the hospital, forget everything they were told by a doctor or nurse?

That key moment when the patient should be listening to post-discharge instructions is one of the primary pain points of patient-provider communications. Instead of learning what steps to take to get healthy and stay healthy – and most importantly to prevent a return to the hospital – the patient is focused solely on going home.

That's the impetus behind Good to Go, the mobile platform developed by ExperiaHealth, a subsidiary of Vocera Communications, which digitizes discharge instructions and other patient-specific information and makes them available to patients and their caregivers via phone, computer or mobile device.

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Cullman Regional Medical Center in Cullman, Ala. tested the solution in October 2011 – before Vocera even had a chance to name it. Cheryl Bailey, BSN, MBA, the hospital's chief nursing officer and president of patient care services, said she chose to test it in a 30-unit wing of the hospital that catered primarily to patients with chronic conditions – patients whose post-discharge instruction were traditionally more complex.

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"They're focused on the door, they're ready to go home, and they're not really listening to what a doctor or nurse is telling them," Bailey said during an interview with mHealthNews. "Or else their primary caregiver isn't in the room with them when they're getting these instructions, so later they're trying to remember them and recite them … and they can't remember what they were told."

According to Bailey, nurses or doctors are now equipped with an iTouch device, which they use to record their post-discharge instructions to patients. Those instructions are then stored in a secure portal along with condition-specific education (including videos) and follow-up appointment reminders, which the patient and his or her caregivers can access via a secure PIN code.

In the months that followed Cullman's launch of Good to Go, Bailey said, officials saw a 15 percent reduction in patient readmissions. In addition, Cullman's Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores saw a 62 percent to 63 percent increase in patient satisfaction rates for understanding of post-discharge care instructions.

"It's helped us bridge that communication gap," said Bailey, who has since deployed Good to Go in several departments throughout the hospital, from pediatrics and maternity to the pharmacy, outpatient services and even patient financial services.

Bailey sees other uses for the technology as well. Since all entries are logged and recordings monitored by supervisors, the platform can be used to evaluate staff on their patient communications skills. In addition, if a specific patient logs in several times to review the post-discharge instructions, a nursing director can be alerted to check in with that patient to make sure there are no ongoing issues.

Staff initially were reluctant to use the technology, Bailey said, because they "didn't want to hear themselves on a recording." But with time, she said, they've come to see the service as a means of improving their communication skills with patients.

"They're now going into that room doing a much better job (with post-discharge instructions). They're doing a much more thorough job," she said.

"Everyone's on board to do this now," Bailey said, explaining that she wants to add more resources – especially more videos and links to disease treatment literature – to the Good to Go platform. "The real challenge has been trying to find the time to get this onto their schedules."

Cullman's success with the Good to Go platform has earned Vocera several honors, including a 4th Annual Dorland Health "Case In Point" Platinum Award for Discharge Planning Program and a 2013 Robert Wood Johnson Foundation "Care About Your Care" nomination.

Steve Jackson, ExperiaHealth's chief operating officer in a prepared statement attributed that to working closely with early partners such as Cullman, with a focus on not only reducing readmissions but improving the overall patient experience.

Good to Go is “making a significant impact on how we engage our patients at discharge,” said Michael Palumbo, chief medical officer at White Plains Hospital in White Plains, N.Y., in a press release last May. "Based on initial results, we plan to expand the solution to our ambulatory surgery department to enhance our teaching with same-day surgery patients and family members."

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